Association of Preoperative Neutrophil/Lymphocyte Ratio with Clinical Outcomes in Dedifferentiated Chondrosarcoma Patients

Background: Dedifferentiated chondrosarcoma (DC) is an extremely uncommon malignant bone tumor with dismal survival outcomes. The purpose of this study was to investigate whether the preoperative neutrophil/lymphocyte ratio (NLR) has the ability to predict overall survival (OS) in DC patients. Materials and Methods: Twenty-three DC patients with surgical resection were retrospectively reviewed between 2008 and 2015. The clinical pathological information and survival data were collected for analysis. The cut-off point for NLR was defined by receiver operating curve (ROC). The impact of NLR level on OS between two groups was compared using Kaplan-Meier curves with the Log-rank test. The association between NLR and OS was calculated by univariate and multivariate Cox proportional models. Results: From the ROC analysis, the optimal NLR cut-off point was 3.11. Patients with high NLR had a worse OS than low NLR (p = 0.003, Log-rank test). In univariate analysis, a significant association was observed between high NLR and poor OS (Hazard ratio (HR) 4.62, 95% confidence interval (CI) 1.48-14.34, p = 0.008). After adjustment of co-variables, high NLR had more than 4 times the risk of mortality (HR 4.01, 95% CI 1.12-14.26, p = 0.032). Conclusion: Preoperative NLR in peripheral blood is an easily accessible and cost-effective prognostic biomarker in DC patients. A prospective study with large sample size is warranted.